A.Blue Cross and Blue Shield Association based in Chicago is a national federation of 37 independent, community-based and locally operated Blue Cross and Blue Shield companies, its website states.

The association owns and manages the Blue Cross and Blue Shield trademarks and names in more than 170 countries and territories around the world, granting licenses to independent companies to use the trademarks and names in exclusive geographic areas.

Those independent companies, in turn, own and fund the association which is governed by a board of directors from which two-thirds are selected from member companies.

Health insurance plans under the trademark cover 100 million people, or one in three Americans.

Q.Is Blue Cross and Blue Shield nonprofit?

A. The association is set up as a nonprofit in Illinois and reported $400 million in revenue for 2011, according to its tax filings.

Blue Cross and Blue Shield of Alabama is also set up as a nonprofit. But numerous other Blue Cross Blue Shield companies are not because of tax reform in the 1980s.

Birmingham, Alabama —A hearing on previous filed Motions to Dismiss in the Blue Cross Blue Shield antitrust litigation was held in Birmingham, Alabama on Wednesday. The hearing, conducted in Birmingham, Alabama, will result in an Order that will determine the status of the case going forward. Lead attorneys for both sides made arguments supporting their positions in the 6 hour session.

The hearing, conducted in Birmingham, Alabama, will result in an Order that will determine the status of the case going forward. Lead attorneys for both sides made arguments supporting their positions in the 6 hour session.

The lawsuits, consolidated before Judge David Proctor in the Northern District of Alabama in MDL 2406, allege that the Defendant Blue Cross Blue Shield entities conspired to violate federal antitrust regulations by allocating health insurance markets. The complaints allege that they did so in a manner that eliminated and stifled competition and increased profits for Blue Cross Blue Shield at the expense of doctors and other health care service providers, large and small businesses that purchased insurance for their employees and competing health care insurers.

BIRMINGHAM, Alabama — Lawyers suing Blue Cross and Blue Shield for conspiring in Alabama and across the country to illegally stifle competition forcefully argued in briefs filed this week that the case should not be dismissed.

“This case is simple,” begins one of filings opposing Blue Cross’ motion to dismiss the suit.

“The plaintiffs have alleged in detail that the defendant Blue Cross and Blue Shield plans, which are independent companies, agreed with each other to carve the United States into ‘service areas’ in which only one Blue plan can sell health insurance and contract with healthcare providers,” the brief continues. “This practice known as horizontal market allocation, and it is illegal. …”

JACKSON – Health Management Associates has reached an agreement with Blue Cross & Blue Shield of Mississippi, it was announced today.

The agreement means all HMA hospitals, including Amory’s Gilmore Memorial, have been fully reinstated as participating in-network partners, effective Jan. 1, 2014. The HMA hospitals have agreed to permanently drop their lawsuit against Blue Cross, and the latter will not have to pay any money to HMA or its hospitals as a result of the suit’s dismissal.

“I am gratified that the patients and employees who were impacted by this dispute now have peace of mind in knowing that an agreement has been reached,” Gov. Phil Bryant said in a statement. “Earlier this year, I used my executive authority because negotiations had stalled and patient access to care was threatened. I am thankful that both Blue Cross and HMA then returned to the table and worked together to ensure that access to care and patient-doctor relationships are preserved.”

In June the 10 hospitals owned by Florida-based Health Management Associates filed suit in state court, alleging Blue Cross had underpaid them by $18 million. Blue Cross terminated the HMA hospitals from its network effective Sept. 1, saying the hospital system’s charges were out of line.

By Alex Walsh | awalsh@al.com Al.comEmail the author | Follow on Twitter
on December 22, 2013 at 5:00 AM, updated December 22, 2013 at 5:19 AMIf you’re going to talk about health care in Alabama, there’s one company that has to be part of the conversation.Blue Cross and Blue Shield of Alabama is one of the largest businesses in the state with $4 billion in revenue, the insurer with the largest market share in a single state by far, according to the American Medical Association.In Alabama, the state Department of Insurance through a rate review process is by law supposed to make sure that premiums for health service plans, such as Blue Cross, “not be unreasonably high or excessive.” But the federal government has labeled the state’s review process inadequate.

A federal lawsuit winding its way through federal court in Birmingham accuses Blue Cross and Blue Shield of Alabama and about three dozen other Blue Cross plans of conspiring with each other, agreeing not to compete and dividing territory to limit competition.

The class action lawsuit, which alleges violation of federal antitrust laws through a “complete lack of meaningful competition,” helps explain the relationship between BCBS of Alabama and the broader Blue Cross and Blue Shield Association. Local businesses such as BCBS of Alabama, although independently run, are linked by the Chicago-based, nationally run BCBSA with a board of directors.

That BCBS has Bryant and Hood working together should tell you exactly what kind of public and governmental relations nightmare the insurance giant has cooked up for itself. Bryant and Hood both feel snubbed and professionally insulted by BCBS, particularly CEO Carol Pigott. Word from persons close to Bryant and to Hood tell similar stories:

“I have been reviewing intra-state antitrust allegations against Blue Cross for several years,” Hood said in a recent statement. “The immature court filings and refusal to even meet are indicative of a corporation that has achieved monopoly status and thinks it is above the law. We shall see.”

JACKSON – Gov. Phil Bryant may not be ending his battle with BlueCross & BlueShield, but instead may be moving the contest to a different venue – a political venue where he has more expertise – the Mississippi Legislature.